Commercial Sex in Singapore – HIV, STDs and other pitfalls

HIV and STDs in the Commercial Sex Scene in Singapore

Welcome to Singapore. For the uninitiated, commercial sex here is legal. Aside from the regulated commercial sex workers, there are also many unregulated working girls. This article is to give you an idea of the various risks involved if you decide to engage these services.

This article is not meant to encourage or discourage. I will endeavour to state the facts as best I can. As you might already have guessed, good data on this subject is hard to come by. Many of the points made here are based on my personal experience having run a sexual health clinic and having worked at the DSC (government sexual health clinic) and on unpublished data supplied to me during my interactions with the various health authorities.

This article is also not going to discuss the intricacies of how to go about obtaining such services in Singapore. For that, please read this great resource on The Singapore Commercial Sex Scene.

The Law on Commercial Sex in Singapore

The legal age of consent in Singapore is 16.

The legal age for being a commercial sex worker is 18.

In other words you can have mutually consenting sex with a girl above 16. However, if there is financial consideration, she must be above 18 years of age.

If you are above 21, it is no excuse in the eyes of the law to say that you did not know her age or was duped into believing she was older. You will still go to jail and serve a maximum of 7 years.

Wikipedia is a great resource for more details on the law on commercial sex in Singapore.

Geylang – HIV and STD risks

Geylang is currently the official red light district of Singapore.

The 2 extremes of risk are found here. The safest are the regulated sex workers working out of brothels or ‘houses’. The most dangerous are the freelance girls plying their trade by the side of the road, the so-called ‘streetwalkers’.

The regulated sex workers are required to undergo sexual health screening every month. They are screened for HIV, Syphilis, Chlamydia and Gonorrhea. They may also be screened for throat or rectal Gonorrhea if they have had oral or anal sex. Their licenses are revoked if they are infected with HIV or Syphilis. If they have Gonorrhea or Chlamydia, they are given treatment and allowed to continue working. The last case of HIV detected in these sex workers was many mnay years ago. Gonorrhea and Chlamydia cases are seen frequently.

What does this mean to you? Because of the HIV testing window period, there is still a risk of HIV albeit this risk is very small. This in no small part is also due to brothel owners enforcing rather strict (but not foolproof) condom usage.The chance of contracting Gonorrhea and Chlamydia is ever present even if you use a condom. These sex workers are not screened for other diseases like HPV or Herpes so you are still at a risk of contracting one of these.

Streetwalkers are sex workers who operate without a license. They are usually in Singpaore on a short term social visit pass. Some of them voluntarily attend sexual health screening at the government health centre (no; they are not arrested if they do) but most of them do not. There is obviously very little information we have in terms of HIV/STD prevalence in this group of sex workers. Based on data that is a few years old, we know that Vietnamese sex workers have the highest HIV prevalence rate (about 4%). The theory is that Vietnamese sex workers face a language barrier when trying to bargain for condom usage with their clients. So most of them end up not using condoms. Indonesian sex workers come in second in terms of risk. The theory is that they are usually on their way back to Indonesia from working in the sex industry in the Middle East. Diseases contracted when they were in the Middle East usually go undetected or untreated. Also taking into account the reported HIV prevalence rate amongst sex workers in Bali is actually 25%. Thai female sex workers are relatively low risk. However, Thai transexual sex workers are high risk. We do not know the exact numbers. But there was a study in Bangkok that estimated the HIV prevalence rate among Thai transexual sex workers to be approximately 49%. Mainland Chinese are relatively low risk. You hardly see Filipino streetwalkers in Geylang.

Because it is illegal to tout sexual services, the police (more than) occasionally organises a crackdown. There was a time it was rumoured the police were rounding up 100 streetwalkers EVERYDAY. You really do no want to be around when they are slapping these sex workers up in handcuffs.

It is an open secret that these places offer much more than just a massage. It is mostly tolerated by the authorities but occasionally there is a crackdown too. Just make sure that the details you write in the sign-in book at reception are accurate. Woe to he who writes fake details that the police cannot verify during the crackdown.

In terms of sexual health, the risk level is actually thought to be equivalent to the regulated sex workers in Geylang. In other words, rather low risk. In order to maintain a masseuse license in Singapore, the working girls have to undergo HIV, Syphilis, Gonorrhea and Chlamydia screening every 6 months. Yes this sounds like a long time but the fact is also on the average they receive less than half the number of clients compared to ‘full fledged’ sex workers. Because the screening program is still relatively new, we do not have good data to comment on.

Orchard Towers – ‘4 floors of whores’, HIV and STDs

No surprises that this is neither legal nor regulated. It is however tolerated and I have not personally heard of any police crackdowns at Orchard Towers. If you have please let me know in the comments section below.

The girls working there are quite a hodgepodge so it is difficult to generalize. We can however seperate them into 2 groups roughly. Those who are here on a short term visa and those who have a day job (most often as domestic workers).

The girls who are here on an employment pass and have a dayjob are required to undergo a Syphilis test every 6 months and a HIV test every 2 years. I know this does not offer much reassurance but it is better than the girls on short term visas where we do not know where thay have been or what risks they have taken prior to coming to work in Singapore.

Orchard Towers also poses another unique risk which I have seen a few cases of. Basically, some of these woprking girls are not looking for a quick buck but more of a way out. They would get their targets usually really drunk then go home with them. In the morning after, instead of asking for cash, they are planning to move in and establish a longer term relationship.

Internet Sites

So called ‘online vice rings’, these sites received notoriety when close to 50 people were charged for having sex with an underage girl procured from one of these sites. (See article above).

As a member of one of these sites, you choose the sex worker based on pictures and descriptions provided by the person running the business. Services are then rendered usually in one of the short stay hotels dotted around Singapore. Of course this is neither legal or regulated. We can only hope that the person running the business would take some steps towards ensuring the cleanliness of his sex workers so as not to spoil his reputation and his business. This is purely speculation. I do not have or know of any reliable data. I personally have not seen anyone contract HIV from such online services yet.

Summary

The only way to be 100% sure of not catching HIV or any STDs is to stay in a mongamous relationship.

If you have any kind of contact with a commercial sex worker, you are at risk of contracting an STD or maybe even HIV. This is true even if you wear a condom.

Regulated sex workers are relatively safer.

To protect yourself and the people around you, go for regular screening.

About Dr. TanDr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

217 Comments

I understand the article above was posted in 2014 and you stated that the last known case of HIV from legal Geyland CSWs were many many years back. But its near the end of 2016 now. Can we get updated info in these 2 years did any CSWs from legal houses in Geylang contacted HIV?

Hi Ken. I want to know as much as you do. Unfortunately, this kind of info and data is hard to come by. I have not heard any updates from MOH. However, I surmise that if there was a +ve case in the legal houses, there would be a big hooha about it.

Theoretically speaking if there was contact of infected vaginal fluid with your foreskin or urethra, you are at risk of HIV. But from the way you described your exposure, I would guess that your risk is negligible.

I had sex with licensed sex worker in geylang with condom 20 days ago. I did oral sex (licking) to her around 5 minutes. I feel itch on my buttocks. Is possible to affect by any diseases.I am worried.
Thank you.

Dr
One week ago, I had sex with regulated CSW girl at a Gaylane brothel. I have protected and didn’t brake condom until completion sex.
My concern is i saw some blood on condom during sex. But I am not very sure it is bood or Just condom color a bit changes in red color because of lighting. But I know this condom originally is yellow color when she put it to my stick before we started sex.
While she on top me, base of my stick changed the red color because my condom is not fully cover until base of my stick. Then I quickly finished it and washed with water to my genital area. The problem is my tip of stick has small dented when I checked after reaching my home. Then the next day, I went down and see the girl again and asked her about her mendtrustion period. She said it is not yesterday and she has monthly medical checked. She also said that this is her 1st time in Singapore and she had pass medical checked before starting work and she started work on August 5. She also checked again on 25 August as per monthly schedule at Kelanton Road clinic. I took her ph number and keep in touch. She said that she is not working yesterday and today because she sick. I am also pain body and feeling sick.

My questions are
1) if they are checking the HIV test monthly, what kind of test they use. 4th generation P24 or 3rd generation antibody test or normal? She said they have to pay about 65 $ for checking.
2) menstruction period, they are allowed to work ?
3) how safe these regulated sex worker are ?
4) I am too much worry now and what is my risk level ?

1. I have not worked at the Kelantan Lane Clinic for a very long time. So I do not know what tests they are currently using.
2. As far as I know, there are no laws to forbid a CSW to work during her period.
3. I do not know how to answer this question. They get monthly checks. That is all I can say.
4. I also do not know how to answer this question. The fact is there is no such thing as 100% safe sex. I think that is obvious. Using a condom and visiting a legal CSW reduces your risk considerably but it would be naive to think that gives you a solid 100% guarantee that you will not get any kind of infection.

Hi dr, am feeling v anxious and would appreciate if you could ans my qns. I visited a massage parlour and received an unprotected handjob.during the massage her thighs touched my penis sparingly for split seconds. Her thighs felt smooth and I doubt there were open wounds. I checked her hands later and they were normal with no cuts or wounds. However I kissed her on the lips twice for like 1 second each time, dont remb tasting her saliva. Her lips looked normal with no sores. Any risk of std like hep b or herpes?

Also I forgot to add that my lips were a little dry, however when I checked there was no ulcers or open cuts or wounds in my mouth or lips, just a small little crack at the corner(which I’m not even sure is a crack). At the tiny crack, there was no blood, pain, and it didn’t feel like an open wound. Don’t think her kiss touched that part much. Any chance of hep b or herpes infection?

The risk of Hep B is negligible. Hep B is spread via body fluid. However, the risk of Herpes is always present. Herpes is spread via direct contact with infected skin. So in the event that she had an active Herpes infection on her finger (called a Herpetic Whitlow), you could catch it too.

Thanks so much Dr tan. Oh I have 2 more question.
1) I remember I kissed her on her clean shaven armpit and licked it. Might have tasted a bit of sweat, no blood was seen or tasted. Any chance of any std?
2) I think my lips were dry and the skin was peeling but no blood or open wound noticeable whatsove. Any chance of hep b when I kissed her on the lip?

Hi, I was going to treat myself to an outcall tantric 4 hands massage in singapore from an online massage service. As I understand, 2 masseuses are wearing their underwear or are naked and massage you whilst you are naked.

Given that they would be rubbing their bodies over your exposed thighs, genital area and buttocks etc, and then giving you a happy ending hand job, is there a risk of herpes?

i really would love to relax and have this, but at the same time I don’t want to risk any future happiness for short term fun? Basically is it a bad idea?

Yes there is a risk of Herpes. I cannot say if it is a bad idea or not. I do not judge. I can tell you a medical fact that if your skin comes into direct contact with Herpes infected skin, there is a risk that you can get infected.

Thanks. I mean the massage website sounds great. I am a virgin, and am clean of STDs.

From what I understand, the masseuses are wearing underwear covering their genitals. If I am naked and if they are on top of me, given my genitals are exposed to their thighs, is there a risk of herpes?

Herpes is transmitted via direct contact with infected skin. Theoretically as long as there is direct contact with potentially infected skin (eg thighs) there is a risk of infection. The only sure way of protecting yourself from HIV and STDs is to abstain from any sexual contact or to stay mutually monogamous with a partner who is also free of HIV and STDs.

i recently had sex w a girl. all i know is that she had unprotected sex before and im worried that her previous partners have a std. can i know how im supposed to get a check for stds without any possible way of parents knowing?

I had sexual encounter with online social escorts on 2nd May and also in early April and early March. I used condom throughout however I received oral sex before I used the condom for vaginal intercourse. Earlier in the middle of this week on 4 May, i had a suddenly itch on my forearm and started to develop some rashes. The rashes looked like scratches. In the evening, after I removed my socks at home, i noticed my tiny little red spots on both of my lower legs, inside the hair follicles. What are the STDs that I could have caught? Has there been any cases of people getting infected with STD despite practising safe sex with condoms? I only engage the social escorts that are online.

I had sexual encounter with online social escorts on 2nd May and also in early April and early March. I used condom throughout however I received oral sex before I used the condom for vaginal intercourse. Earlier in the middle of this week on 4 May, i had a suddenly itch on my forearm and started to develop some rashes. The rashes looked like scratches. In the evening, after I removed my socks at home, i noticed my tiny little red spots on both of my lower legs, inside the hair follicles. What are the STDs that I could have caught? Has there been any cases of people getting infected with STD despite practising safe sex with condoms? I only engage the social escorts that are online. Hope they are safe.

I would like to bring 3 points up here. 1. I think it is rather naive to hope or think that sex workers are “safe”. It is best to still be cautious. 2. Even if you are careful, the fact remains that you can catch MANY STDs even if you use condoms. Here is another sobering fact: condoms are only 87% protective against HIV. 3. None of the symptoms you described are typical of any STDs. Howeever you should still see a doctor for proper advice and diagnosis.

I had sex with a viet girl in orchard towers. We used comdom during sex but she gave me a blowjob without condom. But evrytime we have sex i always use condom. We also kissed a lot. I am worried bec 4 days later she told me she was sick and the doctor prescribed her azithromycin, some cough syrup promedyl and beathricin..i searched the azithromycin drug and i saw thats irs used to treat clam or gonorrhea..im woried cos i have sore throat and feverish symptoms now..so far now pain in urinating yet..pls advise..thanks!

Azithromycin is being used for treatment of some STDs. It can also be used to treat many other infections such as lung infection.
If you are concerned, please see a doctor and get yourself assessed and tested.http://www.drtanandpartners.com/where-to-find-us/

i had sex with a chinese prostitute streetwalker at geylang. When i was ejaculating and pulled out, my condom slipped out of my shaft. A few days later i developed a slight fever and sorethroat. Am i at risk of contracting HIV?

Hi doctor,
please answer me I’m so worried.
I had sex in Geylang in a legal house. The man said the girls are Thai. In the middle of the sex I suddenly noted condom is slipped out. I think I’ve done sex for about 2-3 minutes without condom. I interrupted the sex and asked the girl many times that if she had any diseases. Her English was good enough and she said that she is completely healthy and goes for check up every month. I asked from the owner for the health certificate of the girl but he said he could not show it to me.Now after almost 90 hours I feel I’m burning from inside specially in my feet’s bottom. I also have small itching in my ears. but have no sign of flu.
Am I susceptible to HIV? How much is the risk percentage for a girl having HIV in a legal house?

There is no way you can ascertain the status of the sex worker. Therefore, based on your exposure, you are at risk of HIV and other STDs. Your symptoms do not sound like HIV at all.
I would still advise you to get yourself checked properly by doctors.http://www.drtanandpartners.com/where-to-find-us/

I had sex with a massage worker yesterday, and she give me a blowjob before the sex. Both activity are conducted with condom didnt find any damage on the condom. I was wondering which level of risk am i? Is it better if i go get the PEP treatment?

Hi Dr Tan,i was on holiday in Singapore last December and i went orchard tower one day to have look.When i was walking through the building, one sex worker came from side and touched middle of my arm(below biceps).I shake it off and manage go pass her but i felt prick pain where she touch me.i checked my hand that moment and didn’t notice any bleeding or scratches.so went away without checking her hands.7 week has passed since the incident, but now i have a very bitter taste in my mouth for last 6 days.I never had any thing like this before in my mouth.
(1)Any chance it could be symptoms of ARS.
(2)Did i got pricked by a syringe.
(3)Has any one heard this type of situation happened in orchard tower
(4)do i need to get tested for Hiv

I don’t feel fatigue,no fever, no swollen lumps,no flu.

please help me.i’m having high anxiety and stress because of this incident.

You are asking me questions that is impossible for me to answer. I personally have never heard of anyone getting pricked by a syringe at Orchard Towers but I am sure there are many things that happen in Orchard Towers that I do not hear of. You are the best person to know what happened. There is no way I can know and therefore any answers I give you are meaningless.

Hi Dr.
Is the HIV rapid test accurate if I take it 4 weeks from exposure?
I had a handjob from a masseuse at around late November. Am I at risk of HIV? There is no contact with her vagina but she used her spit as a lube.

Herpes is spread by contact with infected skin. Since for Herpes Simplexx, the areas of infection are frequently, the face and the ano-genital region, it can and is frequently passed through sexual contact. However, non-sexual contact like parents kissing children can also easily pass herpes.

I had sex with a register prostitue from one of the house in geylang.. Halfway through sex the condom slipped out.. The prostitue continue to have sex with me without condom and she told me she only does this to me. She told me she went for check ups monthly. We have sex without condom for about 2-3 mins.. I’m super guilty and worried of contracting HIV. I recently got vaccinated for hepatitis by the way.. Can I roughly know what is the chance of contacting or expose to HIV? Are those prostitues safe is a way?

Dear Doctor, should I undergo any tests? I had sex with a lady in one of the brothels in Geylang, with condoms of course. It’s just that Im kinda worried. Should i have myself checked? If yes, when should i go and get that test and what type of test? Thanks a lot!

Using a condom reduces your risk of contracting HIV and other STDs. However, it is not 100% foolproof. Like any other sexually active person, you should get screened for HIV and STDs regularly. It is best to see us 1 month from your last exposure. Unless you develop symptoms then see us earlier. We will discuss with you what kind of tests you need during your visit.

Hi Dr Tan, i have given unprotected oral sex to a female sex worker. i understand that i am at risk of various types of stds. may i know what test i can undergo to conprehensively confirm my status? and when should i perform the test so as to obtain.conclusive results? thank you!

Hi dr. I have protected oral and vaginal sex 3 days ago at one of the house in gaylang. However, i forgotten to remove the condom before i wore back my underwear. About 5 seconds later I removed the condom and wore the same underwear back. Does this increase the risk of infection?

Hi dr tan, i’ve protected sex with one thai girl in a massage parlour, when we changed position i realized the condom broke, that was probably 5mins before i knew it. What are my chances of contracting HIV or any of the STDs?

Dr.Tan,
I had sex with a girl chinese in lorong 18 in the legal brothel house.I asked if they are safe and the brothel said dont worry they are safe. I used condom for vaginal sex. No sign of breaking. we too a shower and then a little touching. BUt i saw the condum was not long enough. I am a bit scared as it was not long enough, because , i fear there may be some contact at the base with some vaginal liquid 9 may be). I also fear is there is any liquid from her vagina contacted while removing , i fear there is some contact. i am on 3rd day. when should i test HI or other tests to acuurately know. and how much they cost?
I will neer do it again. omgod.